摘要
肺炎支原体（Mp）是一种无细胞壁、具有对粘膜表面高度适应和吸附特性及细胞内感染并生存的最小微生物。Mp含有与人体许多组织共同的抗原成分。除呼吸系统外，Mp感染及其引起的免疫损伤可造成肺外多系统急慢性病变。Mp引起的肺外病变分2型：Ⅰ型为Mp直接侵袭致病，Ⅱ型为Mp引起的免疫损伤。其临床表现复杂而缺乏特异性，对诊断预示作用有限。检测血清特异性抗体及PCR等检测气管，肺泡液Mp DNA有诊断价值；部分病人确诊需结合流行病学、临床表现、有关检查结果及治疗效果综合分析。治疗主要为抗Mp及抗免疫损伤，前者首选大环内酯和喹喏酮类药物，后者主要为糖皮质激素；其中以红霉素和阿奇霉素等应用较多，既能抑制Mp粘附．杀灭Mp，又能缓解Mp引起的变态反应性炎症。
Mycoplasma pneumoniae （Mp） is one of the smallest bacterial agents characterized by lacking cell walls, adhering and adapting on mucosal surfaces and invading and replicating within host cells. Mp contains many antigens which can cross react with human host tissues. In addition to the respiratory track, Mp infection-associated immunological injury occurs in extra-respiratory systems. Mp-induced extra-respiratory injury can be divided into two types. Type Ⅰ is related to the direct injury caused by the Mp tissue invasion and type Ⅱ is the injury mediated by Mp-induced host autoimmune responses. Clinical manifestations of Mp infections are complicated and nonspecific, which provide limited diagnosis information. Serology and PCR on throat swabs, sputa or broncho-alveolar lavages are valuable to provide definitive diagnosis of Mp infections. Diagnosis is made based on the combination information of epidemiology, clinical manifestations, laboratory findings for and empirical therapy response in some cases. The principlestreating Mp infections are mainly anti-Mp and anti-immun- ological injury. Macrolides and quinolones are selected first due to their ability to inhibit Mp＇s adherence to mucosal surfaces. Steroids can be used to alleviate the hyper- responsiveness induced by Mp infections.
出处
《世界感染杂志》
2005年第4期277-282,共6页
World Journal of Infection
关键词
肺炎支原体
感染
病原学
临床表现
诊断
治疗
Mycoplasma pneumoniae
infection
pathogen
clinical manifestation
diagnosis
treatment
